• Title/Summary/Keyword: Esophageal dysphagia

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A Traction Diverticulum of the Mid-thoracioc Esophagus: A Case Report (식도의 중부계실: 1례 보고)

  • 김규태
    • Journal of Chest Surgery
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    • v.8 no.1
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    • pp.51-56
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    • 1975
  • The typical traction diverticulum of the mid-thoracic esophagus is conical or funnel shaped with a wide orifice, is small (rarely exceeding 2cm in length), and is situated horizontally or extends superiorly. It is a true diverticulum, having a complete investment by the esophageal muscle coats. Each of these characteristics promotes easy emptying of the diverticulum. Since food accumulation is presented, there is no tendency to progressive enlargement of the sac, and no associated dysphagia. The diverticula of mid-esophagus rarely develop and rarely produce symptoms. When symptoms develop, they are usually caused by granulomatous infections of the mediastinal lymph nodes. And also such diverticula only rarely give rise to significant complications, the most serious of which is a tracheobronchial fistula. Generally when such complications develop or a diverticulum itself produces symptoms, moderate or severe, surgery intervenes. A case of mid-esophageal diverticulum, traction type, which surgically treated with good results, was experienced at the Department of Thoracic Surgery of Kyung-Pook University. School of Medicine. In this case, there were substernal discomfort, acid regurgitation, and back pain for about 6 months. On the operative findings, it was noticed that the diverticulum was developed by traction and adhesion of perihilar nodes to the esophageal wall. The diverticulum was a small finger tip size and the neck of it was obscure. The surrounding inflammatory change was minimal.

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Thoracoscopic Surgery of Upper Esophageal Leiomyoma -One Case Report- (흉강경을 이용한 상부식도 펑활근종의 수술 치험 -1례 보고-)

  • 정진용;심성보
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.585-588
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    • 1996
  • We experienced a case of upper esophageal leiomyoma successfully excised by thoracoscopic surgery. A 29-year-old male was presented with retrosternal discomfort and mild dysphagia and an esophagogram revealed smooth fElling defect In the upper third of the intrathor cic esophagus, and esophagoscopy showed a submucosal tumor without mucosal infiltration. Chest CT and MRI were performed to confirm size, character and location of the esophageal mass, the absence of infiltration of surrounding structures, and to define mediastinal Iymphadenopathy. The tumor was excised by thoracoscopic surgery and it was diagnosed as leiomyoma (4$\times$2xlcm in size). The postoperative course was uneventful.

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A Study on the concept of Ulkyuk and Banui (열격${\cdot}$반위의 개념에 대한 소고)

  • 김지미
    • Journal of Life Science
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    • v.7 no.3
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    • pp.241-252
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    • 1997
  • Having examined the literatures on the terminologies. UlkyuK and Banui, the following results were obtained. 1. since Ul accompanies the symptom of dysphagia. it is thoughr ro indicate the disease and ailment in the larynx and pharynx. and the esphangus. 2. Kuyk is used in the contextof Kyuksak. Kyukjung. Bikyuk. Ulsakamnd Ulkyuk. and since it also includes the meaning of Ul. it is thought that disease and ailment in the esophagus. stomach and duodenum are included in this category. 3. Although Ul and Kyuk are differentiated. since they appear in conjunction with the other clinically. they can be refferred to as Ulkyuk. 4. Banui represents the phenomenon of vomiting. because it is oresent in a bad case of Ulkyuk. it can be seen to be included in Ulkyuk. Thus. Ulkyuk and Banui can be refferred to as one. 5.Although the name of an ailments in oriental medicine and that in the western medicine can not be in perfect match. Ulkyuk is refferred to as ailments in esophagus such as esophagitis. esophageal ulcer, esophageal deverticulum and esophageal cancer. while Banui is refferred to asailments in stomanch and duodenum such as stomach cancer. chtonic spasmic gastritis. it is reasonable to differentiate the two in general. As seen above, since the concept of the terminologies. Ulkyuk and Banui are somewhat different among Oriental medicine doctors. a consensus is needed to come up with terms that all can agree on.

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Complete Remission of Unresectable Esophageal Cancer Achieved with Concurrent Chemoradiotherapy: A Case Report

  • Jung Min Lee;Bora Keum;Sang Yup Lee;In Kyung Yoo;Seung Han Kim;Hyuk Soon Choi;Eun Sun Kim;Hoon Jai Chun
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.70-72
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    • 2017
  • A 41-year old woman with dysphagia visited, which was aggravated after eating. On physical examination, there was a palpable mass on the left supraclavicular area. Endoscopic examination revealed a mass on the distal esophagus with irregular mucosa, erythema and a whitish plaque with luminal narrowing. The patient was diagnosed with unresectable esophageal cancer (squamous cell carcinoma, T3N2M1, Stage IV). The patient received CCRT (total 63 Gy) with cisplatin and 5-fluorouracil (5-FU). After CCRT, the patient took an additionally 2 cycles of chemotherapy for consolidation (cisplatin and 5-FU every 4 weeks). After additional chemotherapy, endoscopic examination showed no residual tumor, a chest CT scan revealed that the mass in the distal esophagus had decreased and there was no enlargement of the lymph nodes around the left supraclavicular area. The patient has been in complete remission for 5 years.

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Surgical Treatment for Cervical Esophageal Cancer (경부식도암에 대한 수술적 치료)

  • Kim, Dae-Hyun;Baek, Hee-Jong;Lee, Hae-Won;Park, Jong-Ho
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.253-259
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    • 2008
  • Background: The incidence of cervical esophageal cancer is low compared with that of thoracic esophageal cancer, and the role of surgery for cervical esophageal cancer is limited compared with that of radiotherapy or chemotherapy. This study was carried out to determine the outcome of surgery for cervical esophageal cancer. Material and Method: We analyzed retrospectively medical records of 43 patients who had undergone curative surgical resection for cervical esophageal cancer from January 1989 to December 2002. Follow-up loss was absent and the last follow-up was carried out in February 28, 2004. Result: The mean age was 60 years old and the male to female ratio was 40:3. Histologic types were squamous cell carcinoma 42 patients and malignant melanoma 1 patient. The methods used for esophageal reconstruction were gastric pull-up 32 patients, free jejunal graft 7 patients and colon interposition 4 patients. Postoperative complications occurred in 31 patients (72%), and operative mortality occurred in 7 patients (16%). Pathologic stages were I 3, IIa 14, IIb 1, III 19, and IVa 6 patients. Tumor recurrence occurred in 16 patients (44%), and the 3 and 5-year survival rates were 29.3% and 20.9%. Conclusion: The reported surgical results for cervical esophageal cancer showed somewhat high operative mortality, postoperative complication rates and recurrence rates and a low long-term survival rate. It is suggested that multimodality treatment including surgery is needed for the treatment of cervical esophageal cancer because radiotherapy or chemotherapy without surgery could not relieve dysphagia or resolve the tumor completely.

A Case of Alport Syndrome Associated with Diffuse Esophageal Leiomyomatosis (식도 평활근종증이 동반된 Alport 증후군 1례)

  • Jung, Jin Young;Kim, Cheol-Min;Lim, Yean Jung;Kim, Ja Hyung;You, Chong Woo;Choi, Bo-Hwa;Hong, Soo-Joung;Park, Young Seo
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1160-1164
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    • 2002
  • We report a case of Alport syndrome associated with esophageal leiomyomatosis, presenting as recurrent pneumonia. A 5-year old girl who had a history of cataract visited the out patient clinic with a complaint of recurrent wheezing and respiratory difficulty which had started five months previously. Chest magnetic resonance image(MRI) and esophagography, checked on the suspicion of achalasia, revealed esophageal leiomyomatosis and renal biopsy revealed Alport syndrome. In the pediatric population, this tumor is a rare cause of dysphagia and is often misdiagnosed as an esophageal motility disorder. Although a number of Alport syndrome associated with leiomyomatosis were reported in the literature, this is a second case report presented with recurrent pneumonia in Korea.

The surgical experiences of esophageal reconstruction with stomach at the middle and lower esophageal and cardia cancer (중,하부 식도및 분문에 발생한 식도 종양의 위장을 이용한 식도재건술의 외과적 치험)

  • 강경민;박재홍
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.626-631
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    • 1996
  • The forty patients with carcirLoma of the esophagus or cardia seen at National Medical Center between November 1983 and April 1994 underwent surgical exploration. The esophagogastrectomy was carried out in 29 of 40 patients, one case through right thoracotomy, the others through left thoracotomy. Two patients underwent colon bypass surgeries due to upper esophageal cancer Transhiatal esop agectomy was performed In one case. Feeding gastrostomy or feeding jejunostomy were performed in 8 patients due to the advanced stage or malnutrition. In this report, we evaluated the long-term results in the 28 patients who underwent esophagogastrectomy for palliation through the left thoracotomy. There were 25 men(89%) and 3 women(11 %), and the mean age was 58.65$\pm$7.15 years(range, 46 to 73 years). The most frequent preoperative symptoms included dysphagia (22), weight loss (15), chest pain (6), vomiting (1), and hoarsness (1). Twenty-three patients had sqamous cell cancers of mid-and lower esophagus and five adenocarcionomas of cardia. One patient died in the hospital within 30 days of the op- eration for a hospital mortality rate of ).7%, Cause of death was sepsis due to anastomotic leakage. There were five additional complications in five patients; acute respiratory distress syndrome (1), post-op- erative bleeding (1), diaphragmatic hernia (1), acute renal failure (1) and late raft stenosis (1). The one year, 1틴o years, and three years acturial survival rate were 75.6$\pm$9.5%, 43.2$\pm$ 11.6%, 21.6: 10.5$\circledcirc$ re- spectively. The average survival was 21.8 months. The data from this study suggest that esophagogastrectomy through the left thoracotomy can achieve resonable long-term palliation for carci- noma of the esophagus. The operation can be performed with a low operative mortality and few serious postoperative complications.

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The study on oriental and western medicine of esophagitis (식도염(食道炎)에 대(對)한 동서의학적(東西醫學的) 고찰(考察))

  • Choi, Chang-woo;Son, Chang-gyu;Cho, Chong-kwan
    • Journal of Haehwa Medicine
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    • v.10 no.2
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    • pp.91-96
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    • 2002
  • We arrived at the following conclusions after we have studied esophagitis through the literatures of oriental and western medicine. 1. The western medical causes of acute esophagitis are corrosiveness chemical material, esophageal or gastric disease, trauma, blister stomatitis, filamentous fungus infection and uremia of chronic patient etc, and the oriental medical causes are qi and blood stagnation, blood stasis and stagnation, stagnant phlegm by coldness, heating, dyspepsia and food poisoning etc. 2. The western medical causes of chronic esophagitis are malfunction of lower esophageal sphincter, esophageal tom chink and hernia, increase of gastric pressure by overeating, fatness, pregnancy and ascites etc, and the oriental medical causes are asthenic cardiac qi, hepatic qi attacking stomach by seven kinds of depression, cold-damp stagnation and insufficiency of gastric qi by overeating, excessive drinking and sexual indulgence etc. 3. The main symptoms of acute esophagitis are severe chest pain, instantly vomiting, swallowing pain etc, and chronic esophagitis are occasionally light chest pain, heart bum, anorexia, dysphagia, dizziness, general body weakness etc. These symptoms are come under thoracic obstruction, acid regurgitation, vomiting and chest pain of oriental medicine. 4. The western medical diagnoses of acute and chronic esophagitis have used radiation test, esophageal endoscopy, esophageal pressure test and biopsy etc, and the oriental medical diagnoses have used syndrome differentiation by four examination of inspection, listening and smelling examination, inquiring, pulse-taking and palpitation. 5. The western medical treatments of acute esophagitis have regarded preservation stability of esophagus as a principle, and the oriental medical treatments mainly have used expelling pathogen of expelling cold and regulating qi, cooling and removing stasis, promoting blood circulation to remove blood stasis, eliminating phlegm and regulating qi. 6. The western medical treatments of chronic esophagitis have regarded decrease flowing backward of gastric juice as a purpose, and the oriental medical treatments mainly have used strengthening body resistance of replenishing and strengthening cardioqi, dispersing stagnated hepatoqi, expelling cold and dehygrosis, invigorating stomach and nourishing qi.

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Esophageal Foreign Bodies : Experiences of 235 cases for 12 years (식도이물;12년간 235례의 경험)

  • Choi, Geon;Ko, Tae-Ok;Song, Jong-Seok;Chae, Sung-Won;Jung, Kwang-Yoon;Choi, Jong-Ouck
    • Korean Journal of Bronchoesophagology
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    • v.3 no.1
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    • pp.115-121
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    • 1997
  • We have clinico-statically analysed the 235 cases of esophageal foreign body during the period the past 12 years from March InS to December 1996 at the Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Guro Hospital. The results were as follow : 1) Coin was the most frequent foreign body in the esophagus(172 cases : 73.2%). Bone was the next frequent foreign body (21 cases 8.8%). 2) In sex distribution, 124 cases(52.8%) of patients were the female and 111 cases(47.2%) were the male, so the sex ratio was 1:1.12. 3) In the age distribution, 134 cases(56.9%) were under 5 years of age, coin was the most frequent materials in this age group(111 cases 47.2%). 4) The most common symptom was vomiting(136 cases : 57.9%). The next common symptom was dysphagia and odynophagia was 41 cases(17.4%) 5) The most prevalent site of lodgement was the first narrowing(181 cases : 77.0%), the third narrowing(31 cases : 13.2%) and the second narrowing of esophagus(23 cases 9.8%) in order. 6) In duration of lodgement, 207 cases(88.1%) were lodged for one day. 7) The foreign bodies of esophagus were removed successfully by esophagoscopic procedure under local or general anesthesia. There were 3 cases of complication, one case of esophageal bleeding and two cases of esophageal rupture.

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Dental management of the patient difficulty in swallowing (섭식연하장애와 치과적 관리)

  • Hyun, Hong-Keun
    • The Journal of the Korean dental association
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    • v.53 no.11
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    • pp.789-794
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    • 2015
  • Swallowing disorders or dysphagia, which are difficulties with the act of swallowing, can occur at different phases such as oral, pharyngeal, and esophageal phase in the swallowing process. These disorders can be caused by structural, functional abnormalities or psychological problems. Dentists can actively provide patients suffering from dysphagia with comprehensive professional care, especially from the cognitive stage of food to the pharyngeal stage of the swallow. Many cases of dysphagia can be improved with careful managements based on dental professionals' knowledge, including meticulous evaluation of masticatory and swallowing functions, training on eating and swallowing, and fabrication of palatal or lingual augmentation prosthesis. The important thing is that prevention of these disorders through the oral health care instruction and planned follow-up dental visit at periodic intervals in order to manage the problems caused by anatomical, functional, and psychological reason.